The Ministry of Health has highlighted inadequate funding and a limited number of supervisors and hospitals with the necessary capacity as major obstacles to deploying all medical degree holders for internships. According to the Ministry, the government has allocated Shs35 billion to facilitate the deployment and allowance payments for medical interns and Senior House Officers (SHOs) during their 12-month internship placement.
SHOs, who are experienced doctors pursuing specialized training, receive compensation for their clinical services in hospitals, thereby addressing service delivery gaps. However, this funding is only sufficient for 1,500 medical interns and 743 SHOs, while there are 2,706 interns eligible for deployment.
“This Financial Year 2024/25, the Ministry of Health was allocated UGX 35,661,600,000 to cater for both Medical Interns and SHOs. The cost of deploying one intern for one year, inclusive of allowance and PAYE tax, totals UGX 15,600,000,” explained Health Minister Dr. Jane Ruth Aceng. Each medical intern receives an allowance of Shs1,000,000 per month, with PAYE tax adding Shs300,000 per month, totaling Shs1,300,000 per month.
For the 743 SHOs over the 12-month period, the Ministry will use Shs11,590,800,000 from the Shs35.6 billion. “The funding released last year was Shs46 billion, which included arrears and supplementary funds for shortfalls. This year, only Shs35,661,600,000 has been allocated, a reduction of Shs10,338,400,000,” Dr. Aceng explained.
With the available budget, only Shs23,400,000,000 is available for the deployment of current interns, which can only accommodate 1,500 interns. As a result, the Ministry can only deploy the cohort of 2023 and previous years, totaling 1,435 Medical Interns. For the remaining 65 positions, priority will be given to Dental Surgeons (22) and Government-sponsored pharmacists from the 2024 cohort (43).
“This year, we have received communication from the Ministry of Finance, Planning, and Economic Development to operate within the available resources with no anticipated supplementary funds,” Dr. Aceng said. However, calculations indicate that Shs18.8 billion is required to deploy all the interns, raising questions about the government’s priorities in managing the Shs72 trillion budget for this financial year.
Mr. Jim Mugunga, the Finance Ministry spokesperson, stated, “We allocate money based on the resource envelope. I am not aware of a single need that can be 100 percent funded.” Last year, the Ministry deployed 1,901 medical interns, a number described as too large for effective supervision, affecting the quality of training.
“Due to the enormous pressure to deploy all the interns last year, we deployed an excessive number of interns (1,901) that overwhelmed the system,” Dr. Aceng explained. “This created challenges with some trainers having to supervise 5-6 medical interns, resulting in sub-optimal learning, overcrowding, and difficulties accessing medical supplies, equipment, and devices.”
Prof. Medi Kawuma of the Health Service Commission suggested that the government expedite the regulation of student enrollment in medical courses to address the problem, noting that many medical schools produce underprepared graduates. “You find a school with 100 students given two dead bodies to study and dissect. That is not enough. Some don’t have a chance to hold a knife and dissect,” he said.
Prof. Kawuma also highlighted that delayed internship deployment means students are deployed later, after forgetting much of what they learned. Dr. Aceng recommended prioritizing internship training and allocating adequate funding based on the number of students enrolled in universities.
“There is an urgent need to recruit more specialists/supervisors in hospitals and open more internship training centers to accommodate the growing number of interns,” Dr. Aceng said. “The Ministry urges all universities to communicate the number of students (potential interns) at the beginning of the last year of training in line with the Government budgeting cycle.”
“There is an urgent need for the Ministry of Education and Sports to expedite the process of completing the Education for Health Training Policy. We thank all eligible interns and the public for their understanding as we strive to improve the healthcare system in Uganda,” she added.
